HomeMy WebLinkAboutF2023-0325 - Permit ApplicationWorksheet for Fire Permit Application
Print Form City of Newport Beach - Building Department
Please print 3 copies
Associated Building Permit # XIC201S _ 00 %3
UW
r Fire Sprinkler r Fire Alarm r" Fire Misc
1. Project Address (Not mailing address)
4400 MacArthur Blvd., Newport Beach, CA 92660
Tenant Name Greenlaw
2. Description of Work
Installation of new audio-visual notification appliances (10 devices)
Extg Sq Ft 4,996 New/Added Sq Ft
r New j- Add r Alter r Demo
Floor Suite No
570
# Units F
Use
Valuation $ 3,728
Total Sq Ft r
# Stories F
Check Appropriate Box for Applicant/Notification Information
r 3. Owner's Name
Last First
Owner's Address
Owner's E-mail Address
City � �
State F_ Zip F_ Telephoned
F 4. Architect/Designer's
Name Last Beskhairoun First Soty Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
1354 S. Parkside PI.
City Ontario
State CA Zip 91761 Telephone 909-957-5200
i- 5. Engineer's Name
Last First F Lic. No.
Engineer's Address
Engineer's E-mail Address
City F_
State f — Zip r— Telephone
r 6. Contractor's Name
Last Williams First Dominique Lic. No. 905493 Class c7c10c16
Contractor's Address
Contractor's E-mail Address
1354 S. Parkside PI.
Eng5@hcisystems.net
City Ontario
State CA a Zip 91761 Telephone 909-957-5200
OFFICE USE ONLY
�� y�� r� PERMIT NO.
TYPE OF CONSTRUCTION 11�J Q o PLAN CHECK NO. �Go��oT �✓ -15-75
OCCUPANCY - GROUP
�� 0 n_� PLAN CHECK FEE $